JACKSON HOSPITAL AND CLINIC, INC. (NPI# 1538455613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538455613 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC, INC. |
| Other Organization Name | JACKSON CLINIC VASCULAR SURGERY |
| Practice Address |
1725 Park Pl Suite 300-a Montgomery AL 36106-1123 |
| Mailing Address |
1722 Pine St Ste 503 Montgomery AL 36106-1103 |
| Practice Telephone | 3342938000 |
| Mailing Telephone | 3342709914 |
| Mailing Fax Number | 3342703195 |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MRS. TARA HERRING (REVENUE CYCLE DIRECTOR) |
| Authorized Official Telephone | 3342402337 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jackson Clinic Vascular Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477029072 | Jackson Hospital and Clinic, Inc. | Obstetrics & Gynecology | 1722 Pine St Ste 603, Montgomery, AL 36106-1114 | 2018-10-22 |
| 1497240998 | Jackson Hospital and Clinic, Inc. | Internal Medicine | 1722 Pine St Ste 801, Montgomery, AL 36106-1108 | 2018-06-27 |
| 1477171072 | Jackson Hospital and Clinic, Inc. | Family Medicine | 204 Medical Center Dr, Prattville, AL 36066-7288 | 2020-07-09 |
| 1730727744 | Jackson Hospital and Clinic, Inc. | Specialist | 1840 E Main St, Prattville, AL 36066-5500 | 2019-12-20 |
| 1952949968 | Jackson Hospital and Clinic, Inc. | Pediatrics | 4154 Carmichael Rd, Montgomery, AL 36106-2866 | 2019-12-20 |
| 1205494416 | Jackson Hospital and Clinic, Inc. | Urology | 1722 Pine St Ste 503, Montgomery, AL 36106-1160 | 2019-06-03 |
| 1992296370 | Jackson Hospital and Clinic, Inc. | Surgery | 1722 Pine St Ste 503, Montgomery, AL 36106-1160 | 2018-05-22 |
| 1306229190 | Jackson Hospital and Clinic, Inc. | Hospitalist | 1725 Pine St, Montgomery, AL 36106-1109 | 2015-06-30 |
| 1720325889 | Jackson Hospital and Clinic, Inc. | Family Medicine | 701 Mcqueen Smith Rd S, Prattville, AL 36066-7503 | 2013-01-09 |
| 1710265905 | Jackson Hospital and Clinic, Inc. | Internal Medicine | 1801 Pine St, Suite 203, Montgomery, AL 36106-0165 | 2011-07-22 |
| Street Address |
1725 PARK PL SUITE 300-A |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-1123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336375930 | Jackson Surgery Center, LLC | Clinic/Center | 1725 Park Pl, Montgomery, AL 36106-1138 | 2009-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747205 | Rural Urgent Care LLC | Clinic/Center | 3039 Vaughn Road, Montgomery, AL 36106 | 2020-07-16 |
| 1548733306 | Bennett Family Dentistry, LLC | Dentist | 4270 Carmichael Road, Montgomery, AL 36106 | 2019-01-04 |
| 1588133854 | Lori Leanne Fail | Physical Therapist | 1615 Windsor Hill Court, Montgomery, AL 36106 | 2018-11-16 |
| 1073020749 | Charlene Richmond Harrell | Chiropractor | 2900 Zelda Rd., Suite A, Montgomery, AL 36106 | 2018-01-03 |
| 1780123109 | Montgomery Accident and Injury Center, Inc | Nurse Practitioner | 2900 Zelda Rd, Ste B, Montgomery, AL 36106 | 2017-02-17 |
| 1467843573 | Ernest Porterfield | Non-emergency Medical Transport (VAN) | 4183 Carmichael Road, Suite A, Montgomery, AL 36106 | 2015-02-11 |
| 1114334281 | Daniel Gerald O'bryant | Specialist/Technologist | 1160 Navarro Avenue, Montgomery, AL 36106 | 2014-07-21 |
| 1801213764 | Amanda Hodge | Specialist/Technologist | 4605 Cherry Tree Terrace, Montgomery, AL 36106 | 2014-03-27 |
| 1871861542 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1758 Park Pl Ste 102, Montgomery, AL 36106 | 2011-12-08 |
| 1578862546 | Helping Hands Preventitive Health Center | Community/Behavioral Health | 2015 Mulberry St, Montgomery, AL 36106 | 2011-03-16 |
| Find all providers in zip 36106 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093992646 | William N Veale Jr. | Surgery | 1758 Park Pl Ste 300, Montgomery, AL 36106-1137 | 2008-01-25 |
| 1457330813 | John M Mckinney Jr. | Surgery | 2055 E South Blvd Ste 603, Montgomery, AL 36116-2014 | 2006-01-13 |
| 1669007795 | Southern Specialty Physicians LLC | Surgery | 7085 Sydney Curv, Montgomery, AL 36117-3509 | 2020-03-09 |
| 1588011746 | Jackson Hospital and Clinic Inc. | Surgery | 1801 Pine St, Suite 101, Montgomery, AL 36106-0165 | 2016-05-18 |
| 1578790895 | Justin Alexander Parden | Surgery | 1758 Park Pl Ste 300, Montgomery, AL 36106-1137 | 2009-06-12 |
| 1245411289 | George E Hipp | Surgery | 2055 E South Blvd, Suite 908, Montgomery, AL 36116-2001 | 2007-11-19 |
| 1356404362 | Central Alabama Thoracic & Cardiovascular Surgery, P. A. | Surgery | 2055 E South Blvd, Suite 301, Montgomery, AL 36116-2001 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891296547 | West Alabama Physician Associates LLC | Surgery | 701 University Blvd E Ste 807, Tuscaloosa, AL 35401-7479 | 2018-02-27 |
| 1518473073 | Best Vein Care of Huntsville, LLC | Surgery | 2010 Southpoint Park Circle #170, Huntsville, AL 35801-5480 | 2017-12-20 |
| 1962896613 | Dr. J. Donald Carmichael Pa | Surgery | 2857 Canterbury Rd, Mountain Brk, AL 35223-1201 | 2015-03-19 |
| 1306155460 | Valley Vascular Consultants PC | Surgery | 201 Sivley Rd Sw Ste 530, Huntsville, AL 35801-5163 | 2010-10-06 |
| 1003136896 | Marshall Medical Center South | Surgery | 133 Wall St, Albertville, AL 35951-9300 | 2010-06-03 |
| 1215255757 | East Alabama Surgical Associates LLC | Surgery | 2410 Village Professional Pkwy, Opelika, AL 36801 | 2010-05-07 |
| 1700048998 | Barry L. Fields | Surgery | 4700 Southlake Pkwy, Birmingham, AL 35244-3202 | 2008-06-28 |
| 1942401690 | L.s. Mcgee,jr., M.d.,p.a. | Surgery | 15 W Midtown Park, Suite C, Mobile, AL 36606-4139 | 2007-05-30 |
| 1699784538 | Charles Austin Hunt II | Surgery | 4721 Chace Cir, Hoover, AL 35244-3700 | 2006-08-07 |
| 1144254574 | Lawrence S Mcgee Jr. | Surgery | 15 Midtown Park Drive West, Suite C, Mobile, AL 36606-4139 | 2006-07-10 |
| Find all providers with the same taxonomy | ||||
| City | MONTGOMERY |
| Zip Code | 36106 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.